Robot that can perform 'soft tissue' surgery

Washington: A team of US doctors has shown for the first time that soft tissue surgery can soon be performed entirely by a robot on humans, putting surgery one step closer into the realm of intelligent machines.

Representational picture

The so-called Smart Tissue Autonomous Robot (STAR) succeeded in suturing and reconnecting bowel segments in living pigs -- a procedure known as intestinal anastomosis -- and all the animals survived with no complications.

The STAR robotic sutures were compared with the work of five surgeons completing the same procedure using three methods -- open, laparoscopic and robot-assisted surgery with the well-known da Vinci Surgical System.

The robot's time was longer than open and robot-assisted surgery but comparable to the laparoscopic procedure. The robotic procedure lasted 35 to 57 minutes, while the open surgery took eight minutes.

By all other measures, the robot's performance was comparable to or better than the surgeons'.

"No significant differences in erroneous needle placement were noted among all surgical techniques," the researchers wrote, "suggesting STAR was as dexterous as expert surgeons in needle placement".

"The outcomes were surprising to us that consistence throughout performance was better than surgeons," said Peter Kim, associate surgeon-in-chief at Children's National Health System in Washington.

"The goal again is not to replace surgeons but by having a tool like this and by making the procedures more intelligent, we can ensure sort of better outcomes for patients," Kim added.

While robot-assisted surgery is already used on patients, the execution of soft tissue surgery has remained entirely manual, largely because the unpredictable changes in soft tissues that occur during surgery, requiring the surgeon to make constant adjustments.

Equipped with a robotic arm and surgical tools, STAR combines smart imaging technologies and fluorescent markers to navigate and adapt to the complexities of soft tissue.

According to Kim, they tweaked what the robot was doing about 40 percent of the time. The other 60 percent of the time, the machine did it by itself without any interference.

"We are like expectant parents, we were, every single one of us, were watching very carefully," said Kim.

"But fundamentally proof here is being able to show that soft tissue surgery that could not be autonomously done can be done ... I expect that at some point this could be available to anybody and everybody," he point out.

Simon Leonard, computer scientist at Johns Hopkins University, was part of the team.

"There's a wide range of skills out there" among surgeons, said Leonard, who worked for four years to programme the robotic arm to precisely stitch together pieces of soft tissue.

Putting a robot to work in this form of surgery "really levels the playing field", he added.

The research, appeared in the journal Science Translational Medicine, promises to improve results for patients and make the best surgical techniques more widely available.

It is not clear when the robotic system will be in use in operating rooms, but the researchers wrote that the intent is not to replace surgeons, but to "expand human capacity and capability".